Дисертації з теми "Oral health records"

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.
No Brasil, a rede de sa?de mental proposta pela Reforma Psiqui?trica insere os servi?os intermedi?rios e substitutivos, na busca pela aproxima??o ou ressocializa??o do portador de transtorno mental e comportamental junto ? comunidade. Adotou-se, entre outros servi?os, o Centro de Aten??o Psicossocial, Resid?ncia Terap?utica, Lar Abrigado, Hospital-dia, Leito Psiqui?trico em Hospital Geral. Nesse contexto, o Estado do Rio Grande do Norte, implantou o Hospital-Dia Dr. Elger Nunes (HDEN) em Natal/RN no ano de 1996 ligado ? Secretaria Estadual de Sa?de P?blica. No HDEN acontecia um trabalho terap?utico multi e interdisciplinar, al?m de ser palco de pr?ticas disciplinares e projetos de extens?o de cursos em gradua??o de Institui??es de Ensino Superior no munic?pio. Entretanto, com o processo de municipaliza??o dos servi?os locais, o Hospital foi extinto por ato administrativo estadual em 2006, deixando preju?zo para as atividades prestadas aos usu?rios, as pr?ticas disciplinares e as atividades extensionistas. Partindo dessa ruptura, objetivou-se narrar a trajet?ria do HDEN atrav?s dos profissionais da equipe multidisciplinar e dos professores que o utilizaram como campo de pr?ticas disciplinares. Caracteriza-se como estudo documental e qualitativo, respaldado na t?cnica da hist?ria oral tem?tica, seguindo as fases: autoriza??o do colaborador, grava??o da entrevista, transcri??o, a textualiza??o e a transcria??o do material obtido. Utilizaram-se documentos, portarias, relat?rios gerais de atividades, entre outros; somada a realiza??o de entrevistas a quinze colaboradores que utilizaram esse servi?o, sendo treze profissionais da equipe multidisciplinar e dois docentes da gradua??o da ?rea da sa?de, Enfermagem e Medicina. As hist?rias coletadas foram organizadas conforme a t?cnica escolhida, respeitando-se suas etapas. Na prepara??o do corpus submetido ao programa inform?tico ALCESTE, priorizou-se o tom vital para a forma??o das categorias e classes elegida por ele, estruturada sob tr?s eixos tem?ticos. No primeiro eixo denominado Trajet?ria do HDEN rememorou-se o in?cio de suas atividades, os percal?os nesse momento, as atividades desenvolvidas, al?m dos seus atores os usu?rios, familiares, profissionais, e as pr?ticas de ensino. O segundo eixo ocupou-se do Processo de extin??o do HDEN, resgatandose os sentimentos dos colaboradores, as principais justificativas dadas na ?poca e o cen?rio imediato p?s-extin??o. E, o terceiro eixo analisado revelou de forma articulada a situa??o da Sa?de mental em Natal/RN, elencando-se os desafios e perspectivas para a aten??o psicossocial, partindo-se da pr?pria trajet?ria do HDEN com ?nfase nas atividades desenvolvidas. Ademais, a trajet?ria do HDEN propicia o reconhecimento das bases hist?ricas tra?adas na constitui??o da rede de servi?os substitutivos presente no atual cen?rio de aten??o psicossocial do munic?pio de Natal e no RN.

En Côte d'Ivoire, la problématique de l'accessibilité aux soins reste entière en raison de l'insuffisance des infrastructures sanitaires et du manque de ressources financières. Aussi, la population a t-elle souvent recours à l'odontologie traditionnelle pour répondre à ses besoins prioritaires de santé. Cependant, l'absence de données factuelles dans un contexte de pluralité de soins constitue un handicap pour la définition d'une politique de santé bucco-dentaire efficiente. L'objectif de la présente étude a été de décrire l'activité des tradipraticiens, puis de déterminer les facteurs influençant le recours et le renoncement aux soins bucco-dentaires des populations. L'étude de type transversale pilote a portée sur un échantillon de 28 tradipraticiens et 927 adultes. Les résultats ont montré que les consultations bucco-dentaires répresentaient le 1/5 de l'ensemble des activités des tradipraticiens. La majorité des tradipraticiens a déclaré prendre en charge les douleurs bucco-dentaires et était disposé à collaborer avec la médecine conventionnelle. Les tradipraticiens ont déclaré être satisfaits des honoraires perçus. Les ressources végétales et minérales étaient principalement utilisées pour la confection des remèdes. S'agissant de l'étude menée auprès des usagers, alors que les adultes non scolarisés avaient recours en majorité aux tradipraticiens, ceux qui disposaient d'une assurance de santé ou qui avaient le niveau d'étude du secondaire ou plus ont consulté préférentiellement le chirurgien-dentiste. Les adultes ayant un niveau d'étude secondaire ou plus ont eu recours à un tradipraticien en raison de sa proximité. Le recours au tradipraticien en raison de l'efficacité des soins a été plus évoqué par les adultes ayant un âge compris entre 30 et 44 ans, par ceux résidant en milieu urbain et par ceux situés à plus de 15 km du cabinet dentaire. Quant au recours au chirurgien-dentiste en raison de la confiance faite aux soins modernes et la propreté des cabinets dentaires, il a été majoritairement le fait d'adultes vivant dans des habitats modernes. Le renoncement aux soins traditionnels en raison de l'automédication a été le plus évoqué par les femmes. Les adultes situés entre 5 et 15 km du cabinet dentaire ont majoritairement renoncé aux soins traditionnels en raison de la non perception de leur nécessité. Le manque de ressources financières a été le plus évoqué par les adultes vivant en milieu urbain pour justifier leur renoncement aux soins modernes. La non perception de la nécessité des soins a été plus évoquée par les adultes situés entre 5 et 15 km du cabinet dentaire pour justifier le renoncement aux soins modernes. Cette étude a mis en évidence la relation entre l'accessibilité aux soins bucco-dentaires et la pauvreté. Ainsi l'amélioration de l'accès aux soins bucco-dentaires doit s'inscrire dans le cadre global de la lutte contre les inégalités sociales, de l'alphabétisation et de l'aménagement du territoire. En outre, l'odontologie traditionnelle doit être valorisée pour venir en aide au système de santé dans un contexte marqué par l'insuffisance des ressources financières

Oralno zdravlje predstavlja stanje zdravlja svih anatomskih i funkcionalnih delova usne duplje, jedan je od osnovnih elemenata blagostanja i važan pokazatelj kvaliteta života stanovništva. Podaci Svetske zdravstvene organizacije (SZO) ukazuju da je 15-20% svetskog stanovništva srednje životne dobi (starosti od 35 do 44 godine) pod rizikom od gubitka zuba, a oko 30% stanovništva starosti od 65 do 74 godine nema svoje zube. Oboljenja usta i zuba su jedan od vodećih javno zdravstvenih problema 21. veka u svetu i nalaze se na 4. mestu po visini troškova. Osnovni cilj ovog istraživanja je bio da se utvrdi stanje oralnog zdravlja odraslog stanovništva Srbije starosne dobi 20 i više godina i evaluiraju činioci koji na njega utiču. Istraživanje predstavlja deo nacionalne studije “Istraživanje zdravlja stanovnika Srbije” za 2013. godinu Ministarstva zdravlja Republike Srbije, koja je sprovedena u vidu studije preseka na reprezentativnom uzorku od 13690 ispitanika (53,8% žene i 46,2% muškarci). U istraživanju su korišćene tri vrste upitnika koji su dizajnirani u skladu sa upitnikom Evropskog istraživanja zdravlja. Svaki ispitanik stariji za jednu godinu ima 8% veću šansu da svoje oralno zdravlje oceni kao loše (OR=1.08; 95% IP=(1.07-1.09); p=0,000). Ispitanici sa blagim depresivnim simptomima i depresivnim poremećajima imaju 2,04 odnosno 3,48 puta veću šansu da svoje oralno zdravlje ocene kao loše u odnosu na ispitanike koji nisu depresivni (OR=2.04; 95% IP=(1.28-3.26); p=0,003) (OR=3.48; 95% IP=(1.14-10.59); p=0,028). Žene imaju 30% veću šansu da pripadnu povoljnoj kategoriji poseta stomatologu u odnosu na muškarce (OR=0.70; 95% IP=(0.63-0.78); p=0,000). Ispitanici sa nižim i srednjim obrazovanjem imaju 5,70 odnosno 2,45 puta veću šansu da svoje zube operu povremeno u odnosu na visoko obrazovane (OR=5.70; 95% IP=(4.35-7.48); p=0,000) (OR=2.45; 95% IP=(1.91-3.13); p=0,000). Ispitanici najsiromašnijeg sloja imaju 4,88, siromašnog sloja 3,73, srednjeg sloja 2,52 i bogatog sloja 2,01 put veću šansu da izgube 10 i više zuba u odnosu na najbogatiji sloj (OR=4.88; 95% IP=(2.95-8.08); p=0,000) (OR=3.73; 95% IP=(2.42-5.75); p=0,000) (OR=2.52; 95% IP=(1.69-3.76); p=0.000) (OR=2.01; 95% IP=(1.38-2.91); p=0,000). Bivši pušači i pušači imaju 1,43 odnosno 2,80 puta veću šansu da izgube 10 i više zuba u odnosu na nepušače (OR=1.43; 95% IP=(1.00-2.03); p=0,046) (OR=2.80; 95% IP=(2.08-3.76); p=0,000). Najučestaliji prediktori oralnog zdravlja su žene, starije stanovništvo, niže obrazovanje, nezaposleno i neaktivno stanovništvo, najsiromašniji i pušači.
Oral health represents health status of all anatomic and functional parts of oral cavity, it is one of the basic elements of well-being and important quality of life indicator. According to the World Health Organization (WHO) 15-20% of world population aged 35-44 have risk of tooth loss, and about 30% population aged 65-74 does not have own teeth. Oral and dental diseases are one of the leading public health problems in 21st century and on the 4th place of the health care expenditure. The main aim of this research was to assess oral health of adult population in Serbia aged 20 years and older and to evaluate related factors. The research represents a part of “National Health Survey in Serbia 2013” implemented by The Ministry of Health of the Republic of Serbia, which was conducted as a cross-sectional study on the representative sample of adult population in Serbia. The study included 13690 examinees (53.8% females and 46.2% males). Three types of questionnaires which were designed according to the European Health Interview Survey were used. Every examinee older for one year had 8% greater odds to assess their oral health as bed (OR=1.08; 95% CI=(1.07-1.09); p=0.000). Respondents with mild depressive symptoms and depressive disorders had 2.04 and 3.48 times greater odds to assess their oral health as bed compared to one who were not depressed (OR=2.04; 95% CI=(1.28-3.26); p=0.003) (OR=3.48; 95% CI=(1.14-10.59); p=0.028). Females had 30% more odds to be in the category of affordable dental visit compared to men (OR=0.70; 95% CI=(0.63-0.78); p=0.000). Respondents with lower and middle level of education had 5.70 and 2.45 greater odds to brush their teeth occasionally compared to higher educated (OR=5.70; 95% CI=(4.35-7.48); p=0.000) (OR=2.45; 95% CI=(1.91-3.13); p=0.000). Respondents who belonged to the poorest class had 4.88, poorer 3.73, middle 2.52 and richer class 2.01 greater odds to lose 10 and more teeth compared to the richest (OR=4.88; 95% CI=(2.95-8.08); p=0.000) (OR=3.73; 95% CI=(2.42-5.75); p=0.000) (OR=2.52; 95% CI=(1.69-3.76); p=0.000) (OR=2.01; 95% CI=(1.38-2.91); p=0.000). Former smokers and smokers had 1.43 and 2.80 times greater odds to lose 10 and more teeth compared with non smokers (OR=1.43; 95% CI=(1.00-2.03); p=0.046) (OR=2.80; 95% CI=(2.08-3.76); p=0.000). The most frequent predictors of oral health are: women, elderly people, those with low educational attainment, unemployed, inactive and respondents who assessed their financial situation as poor and smokers.

Увод: Хронична бубрежна инсуфицијенција (ХБИ) се дефинише као структурно или функционално оштећење бубрега у трајању од најмање три месеца и/или смањење јачине гломеруларне филтрације (ЈГФ) испод 60 мл/мин/1.73м2. У доступној литератури постоје различити подаци о присуству оралних манифестација код пацијената са ХБИ у квантитативном и квалитативном погледу. Стање бубрежне дисфункције праћено је променама у протоку и саставу пљувачке што је у последњој деценији допринело испитивању клиничких и лабораторијских показатеља бубрежне болести. Циљ: Циљ студије је био да се испита објективно стање оралне слузокоже, вредности рН, сијалометрије, концентрације урее, креатинина и секреторног имуноглобулина А пљувачке као и орални микробиолошки статус код пацијената са ХБИ. Материјал и методе: Узорак је био сачињен од 50 предијализних (31 мушкарца и 19 жена просечне старости 59,06±14,30) и 25 хемодијализних пацијената (18 мушкараца и 7 жена просечне старости 54,92±13,60) са постављеном дијагнозом ХБИ, заједно са 25 системски здравих испитаника компарибилних по полу и старости. Поред клиничког прегледа усне дупље спроведен је тест витроадхезије, одређивање интензитета саливације, рН вредности пљувачке и индекса крварења из интерденталне папиле (PBI). На узорцима сакупљене пљувачке, уз помоћ аутоматизованог система Beckman Coulter АУ480 спроведено је лабораторијско одређивање урее и креатинина методом спектрофотометрије и секреторног имуноглобулина А методом имунотурбидиметрије. За микробилошко испитивање коришћен је брис језика и техника оралног испирка. Резултати: Нису утврђене статистички значајне разлике између група према демографско-социјалним подацима. Предијализни испитаници су имали значајно веће присуство промена оралне слузокоже и оралних симптома. Просечне вредности клиренса креатинина су биле значајно мање код оболелих испитаника са бледилом оралне слузокоже, уремичним задахом, ксеростомијом и измењеним осећајем укуса у поређењу са испитаницима без наведених промена. Код предијализних су утврђене значајно смањене вредности сијалометрије према контролним групама и повећане pH вредности према групи здравих испитаника. Просечне концентрације урее и креатинина су се статистички значајно разликовале између испитиваних група. Умерена позитивна корелација је утврђена између серумских и пљувачних концентрација урее и креатинина код предијализних и креатинина код хемодијализних. Према просечним вредностима секреторног имуноглобулина А није било разлика између група. Код пацијената са ХБИ утврђено је значајно веће присуство гљива из рода Candida са предоминацијом non-albicans Candida врста. Закључак: Резултати истраживања указују на важност утврђивања клиничких карактеристика усне дупље код предијализних пацијената. Интензитет саливације, pH вредност и пљувачне концентрације уремијских токсина могу бити поуздани маркери бубрежног оштећења. Једноставан и неинвазиван приступ приликом узорковања пљувачке и поузданост лабораторијске анализе треба да допринесу широј примени пљувачке као компетитивним дијагностичким флуидом серуму. Техника оралног испирка је прецизна квантитативна метода за одређивање степена гљивичне колонизације.
Uvod: Hronična bubrežna insuficijencija (HBI) se definiše kao strukturno ili funkcionalno oštećenje bubrega u trajanju od najmanje tri meseca i/ili smanjenje jačine glomerularne filtracije (JGF) ispod 60 ml/min/1.73m2. U dostupnoj literaturi postoje različiti podaci o prisustvu oralnih manifestacija kod pacijenata sa HBI u kvantitativnom i kvalitativnom pogledu. Stanje bubrežne disfunkcije praćeno je promenama u protoku i sastavu pljuvačke što je u poslednjoj deceniji doprinelo ispitivanju kliničkih i laboratorijskih pokazatelja bubrežne bolesti. Cilj: Cilj studije je bio da se ispita objektivno stanje oralne sluzokože, vrednosti rN, sijalometrije, koncentracije uree, kreatinina i sekretornog imunoglobulina A pljuvačke kao i oralni mikrobiološki status kod pacijenata sa HBI. Materijal i metode: Uzorak je bio sačinjen od 50 predijaliznih (31 muškarca i 19 žena prosečne starosti 59,06±14,30) i 25 hemodijaliznih pacijenata (18 muškaraca i 7 žena prosečne starosti 54,92±13,60) sa postavljenom dijagnozom HBI, zajedno sa 25 sistemski zdravih ispitanika komparibilnih po polu i starosti. Pored kliničkog pregleda usne duplje sproveden je test vitroadhezije, određivanje intenziteta salivacije, rN vrednosti pljuvačke i indeksa krvarenja iz interdentalne papile (PBI). Na uzorcima sakupljene pljuvačke, uz pomoć automatizovanog sistema Beckman Coulter AU480 sprovedeno je laboratorijsko određivanje uree i kreatinina metodom spektrofotometrije i sekretornog imunoglobulina A metodom imunoturbidimetrije. Za mikrobiloško ispitivanje korišćen je bris jezika i tehnika oralnog ispirka. Rezultati: Nisu utvrđene statistički značajne razlike između grupa prema demografsko-socijalnim podacima. Predijalizni ispitanici su imali značajno veće prisustvo promena oralne sluzokože i oralnih simptoma. Prosečne vrednosti klirensa kreatinina su bile značajno manje kod obolelih ispitanika sa bledilom oralne sluzokože, uremičnim zadahom, kserostomijom i izmenjenim osećajem ukusa u poređenju sa ispitanicima bez navedenih promena. Kod predijaliznih su utvrđene značajno smanjene vrednosti sijalometrije prema kontrolnim grupama i povećane pH vrednosti prema grupi zdravih ispitanika. Prosečne koncentracije uree i kreatinina su se statistički značajno razlikovale između ispitivanih grupa. Umerena pozitivna korelacija je utvrđena između serumskih i pljuvačnih koncentracija uree i kreatinina kod predijaliznih i kreatinina kod hemodijaliznih. Prema prosečnim vrednostima sekretornog imunoglobulina A nije bilo razlika između grupa. Kod pacijenata sa HBI utvrđeno je značajno veće prisustvo gljiva iz roda Candida sa predominacijom non-albicans Candida vrsta. Zaključak: Rezultati istraživanja ukazuju na važnost utvrđivanja kliničkih karakteristika usne duplje kod predijaliznih pacijenata. Intenzitet salivacije, pH vrednost i pljuvačne koncentracije uremijskih toksina mogu biti pouzdani markeri bubrežnog oštećenja. Jednostavan i neinvazivan pristup prilikom uzorkovanja pljuvačke i pouzdanost laboratorijske analize treba da doprinesu široj primeni pljuvačke kao kompetitivnim dijagnostičkim fluidom serumu. Tehnika oralnog ispirka je precizna kvantitativna metoda za određivanje stepena gljivične kolonizacije.
Introduction: Chronic kidney disease (CKD) is defined as structural and functional kidney damage for a period of at least three months and/or reduction of glomerular filtration rate (GFR) under 60 ml/min/1.73m2. There are different data in the available literature in term of quantitative and qualitative presence of the oral manifestation in patients with CKD. Kidney dysfunction is accompanied by changes in the salivary flow and composition, which is in the last decade contributed by examination of clinical and laboratory markers of renal disease. Aim: The aim of the study was to examine condition of oral mucosa, pH value, salivary flow rate, concentration of salivary urea, creatinine, secretory immunoglobulin A and oral microbiological status in patients with CKD. Materials and Methods: The sample was consisted of 50 predialysis (31 males and 19 females, mean age 59,06±14,30) and 25 hemodialysis patients (18 males and 7 females, mean age 54,92±13,60) with a diagnosis of CKD, along with 25 age and gender matched healthy controls. In addition of clinical examination, tongue blade adhesion test, sialometry, salivary pH test and determination of papilla bleeding index (PBI) were conducted. Saliva samples were collected for laboratory analysis performed by automated system Beckman Coulter AU480. Levels of uremic toxins (urea and creatinine) and secretory immunoglobulin A were determinated by spectrophotometric and immunoturbidimetric method, respectively. Oral swab and oral rinse method were used for microbiological examination. Results: The sociodemographic characteristics of the patients with CKD and healthy controls showed no significant differences. Predialysis subjects had significantly higher presence of oral mucosa changes and oral symptoms. Mean values of creatinine clearence were significantly lower in patients with oral mucosa pallor, uremic fetor, xerostomia and disguesia, compared to patients without listed symptoms. Predialysis patients showed significantly decreased salivary flow rate compared to both control groups and significantly increased pH values compared to healthy controls. Mean concentrations of salivary urea and creatinine were statistically different between the groups. Moderate positive correlation was determined between serum and salivary levels of urea and creatinine in predialysis patients and creatinine in hemodialysis patients. Statistical analysis showed no differences between groups in mean concentration of secretory immunoglobulin A. The rate of oral fungal colonisation was significantly higher in CKD patients with predominance of non-albicans Candida species. Conclusion: The results of the present study indicate the importance of determining the clinical characteristics of oral cavity in predialysis patients. Saliva flow rate, pH value and salivary concentration of uremic toxins could be reliable markers of kidney disease. Simple and non-invasive approach due to saliva sampling and reliability of laboratory test should contribute to a wider application of saliva as a competitive diagnostic fluid. Oral rinse technique is an accurate quantitative method for determining the rate of fungal colonization.

Background: Dental comparison can confirm human identity to a high degree of certainty and has always played a major role in Disaster Victim Identification. However, a significant issue for human identification by dental comparison is a lack of adequate antemortem information. Previous research examining Australian-made clinical case notes demonstrated suboptimal recording of dental traits that are important for both forensic dental identification and compliance with Dental Board of Australia record keeping guidelines. In view of this, I have developed and evaluated an online programme of education to improve the clinical and forensic recording practices of oral health providers. Methods: To determine the practical influence of inadequate oral health case note recording on forensic identification, the outcomes of identification case investigations undertaken by the Forensic Odontology Unit of South Australia (FOU SA) over a five year period (2011-2015) were assessed. Subsequently, an online Interactive Learning Module (ILM) was constructed using Articulate Storyline 2 software (Articulate Global Inc.), with the aim to improve skills related to accuracy, detail, legibility, accessibility and retention of dental records. The ILM was initially made available to two focus groups – Australian Society of Forensic Odontology (AuSFO) Inc. members and third year students from the University of Adelaide’s Bachelor of Dental Surgery (2016) program. The ILM was subsequently released to the wider dental community via various professional groups. For all release phases of the study, Likert-style feedback was obtained before and after participation, with percentage, mean, broad agreement and standard deviation being determined for each survey statement. The statistical significance of differences between paired pre- and post-course survey responses were also determined, where relevant. Participants’ country of education, current occupation and level of experience were considered in analysing results. Results: The preliminary investigation into forensic identification cases carried out over a five year period revealed that in 25% of these cases, identity was not able to be established. Furthermore, in 100% of the non-established cases, deficiencies in antemortem dental data contributed to the inability of forensic odontologists to be specific with the identification outcome. This result highlighted the need for further education with regards to clinical record keeping. Surveyed participants from all three study phases reported satisfaction regarding the subsequently-released ILM related to improving antemortem dental case note recording, as considered by Kirkpatrick’s Levels of Training Criteria. Additionally, improvements in the recognition of the importance, knowledge, confidence, skill and motivation to learn regarding the subject matter were seen following participant interaction. Results were particularly noteworthy for participants whose highest degree of education was from Australia, as well as those with only 3-5 years of experience in their current occupation. Individual outlying opinions were recognised and discussed. Conclusion: Lack of antemortem data was shown to limit the ability of forensic odontologists to provide an optimal dental identification. The ILM that was subsequently released to improve education in this area proved valuable in increasing the self-reported awareness, understanding and attitude of participants that had identifiably different levels of previous case note recording experience. By prompting learning, this ILM has the potential to improve record keeping practices and hence aid in forensic dental identification. The information gathered in the process of creating this ILM can also aid forensic odontologists to determine how confident they should be about the accuracy of antemortem records as forensic evidence.
Thesis (MPhil) -- University of Adelaide, Adelaide Dental School, 2017

BACKGROUND: Medical-Dental integration involves the provision of fluoride varnish application, caries risk assessment, anticipatory guidance, and provision of dental referrals by pediatricians during well-child visits. Integration has been recommended as a means to increase access to quality dental care for patients from racial and ethnic minority groups who are at an increased risk of developing oral health problems. METHODS: Guided by the RE-AIM framework (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance), this case study explored the barriers and facilitators for the incorporation of a medical-dental integration program at two community health centers in Massachusetts. Specifically, this study explored the degree to which electronic records were instrumental in the provision and documentation of oral health preventive services during pediatric primary care at the study sites. Data sources included analysis of records from 2014–2015 (before integration) to those from 2016-2018 (post integration), interviews with staff, clinicians, and administrators and direct observations of the workflow at dental and pediatric medicine departments in the study sites. A General Estimating Equation Analysis was conducted to estimate the odds of application of oral health preventive measures before and after electronic dental and medical electronic records were integrated at one of the sites. FINDINGS: During the years post-record integration, children were 40.3 times more likely to receive dental screenings, 2.7 times more likely to receive fluoride varnish during well child visits and 1.6 times more likely to receive fluoride in the dental department within six months of their well child visits compared to the period prior to integration. Respondents identified the complexity, ease of use and accessibility of tools within the electronic medical records as significant factors in success of integration efforts. CONCLUSIONS: Community health centers interested in successfully implementing a medical-dental integration model should invest in sufficient workflow and training resources for the transition to the new records system, develop a simplified protocol for the application of dental preventive services, design accessible electronic tools for documentation of services, and establish accurate reporting systems for both internal program monitoring and external surveillance purposes.

Ching Ho-hong Boby.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2005.
Includes bibliographical references (leaves 63-78).
Abstracts in English and Chinese.
List of Tables --- p.vii
Chapter Chapter 1: --- Introduction --- p.1
General Oral Health Status in Hong Kong --- p.2
"""How"" is the Message Constructed： Gain versus Loss Frames" --- p.3
"""Who"" are the Recipients： Individual Differences in Self-Construal" --- p.4
What Accounts for the Message-Self Compatibility Effects： The Mediating Factors --- p.6
Stage One： Cognitive Integration of the Message Contents --- p.6
Stage Two: Acceptance of the Messages --- p.8
Stage Three： Perceptions of Health Behavior --- p.9
An Addition to the Three-Stage Model: The Role of Anticipated Feelings --- p.11
Overview of the Present Study --- p.12
Chapter Chapter 2: --- Method --- p.15
Participants --- p.15
Oral Health Message --- p.15
Independent Measures --- p.16
Self-Construal --- p.16
Principle Dependent Measures --- p.17
Recognition Memory --- p.17
Subjective Evaluations of the Messages --- p.17
Self-Efficacy to Perform Oral Health Behavior --- p.18
Outcome Expectancy of Performing Oral Health Behavior --- p.19
Anticipated Feelings to Perform Oral Health Behavior --- p.20
Intentions to Perform Oral Health Behavior --- p.21
Behavioral Measures --- p.22
Potential Covariates Measures --- p.22
Personality --- p.22
Need for Cognition --- p.23
Dispositional Optimism --- p.24
Oral Health Locus of Control --- p.25
Dental History --- p.26
Cognitive Ability --- p.26
Mood --- p.26
Perceived Threat of Developing Oral Diseases --- p.27
Perceived Normative Pressure of Performing Oral Health Behavior --- p.28
Fear and Worry Toward Developing Oral Diseases --- p.28
Other Potential Covari ates --- p.29
Procedure --- p.29
Chapter Chapter 3: --- Results --- p.31
Manipulation Checks --- p.31
Different Operationalizations of Gain- and Loss-Framed Messages --- p.31
Principle Analyses： General --- p.33
Moderation of the Framing Effects by Self-Construal on Behavioral Intentions --- p.34
Moderation of the Framing Effects by Self-Construal on Subjective Evaluations --- p.37
The Mediating Effect of Personal Outcome Expectancy on Behavioral Intentions --- p.39
The Mediating Effect of Social Outcome Expectancy on Behavioral Intentions --- p.42
The Mediating Effect of Anticipated Feelings on Behavioral Intentions --- p.44
Chapter Chapter 4: --- General Discussion --- p.46
How to Frame the Message: Tailoring Messages to Match Self-construal --- p.47
Identifying the Mediating Factors of Compatibility Effects Between Message and Self-Construal --- p.49
The Importance of Anticipated Feelings --- p.55
The Intention - Behavior Relationships --- p.56
Improvements and Further Studies --- p.59
Concluding Remarks --- p.61
References --- p.63
Appendix A --- p.79

Le mode de vie des Cris de la Baie James a changé radicalement au cours des dernières années. La carie dentaire est maintenant un problème de santé publique important, et des données montrent que les Cris utilisent les services dentaires en situation d’urgence plutôt qu’en prévention. Il apparaît donc important de savoir si les Cris sont satisfaits des services dentaires publics qui sont disponibles et de mieux comprendre leurs besoins. Ce projet aborde les deux questions suivantes : Quelles sont les attentes des résidants des localités cries pour les services dentaires? Est-ce que les services existants répondent aux attentes des gens? Nous avons mené une recherche qualitative descriptive basée sur des entrevues semi- structurées (n = 13). Les entrevues ont été enregistrées et transcrites. Nous avons ensuite procédé à une analyse inductive-déductive des transcriptions. Les résultats montrent que les participants ont des attentes très variées, mais que celles-ci sont rarement satisfaites. Premièrement, ils veulent accéder rapidement aux services lorsqu’ils en ressentent le besoin, par exemple en présence de douleur dentaire. Les participants désirent aussi transiger avec des professionnels dentaires attentionnés et expérimentés, ce qui n’est pas toujours le cas, selon eux. En conclusion, nous aimerions faire trois principales recommandations : améliorer l’accès aux services dentaires, en particulier en situation d’urgence; entraîner les professionnels dentaires en approches centrées sur le patient et pour en savoir plus sur la culture crie; et dialoguer avec les Cris pour développer, mettre en place et évaluer les services de santé dentaire.
The James Bay Cree have endured significant changes in their way of living. Dental caries is now a major public health concern, and data shows that Cree people tend to use dental services in emergency situations rather than in a preventive way. It is thus important to know if Cree people are satisfied with the public dental services that are provided and what their needs are. This project aims to respond to the following two questions: What are people’s expectations for dental services? Do current dental services meet people’s expectations? We conducted a qualitative descriptive research that was based on individual semi-structured interviews (n = 13). The interviews were audio-recorded and transcribed. We then performed an inductive-deductive thematic analysis. The results revealed that participants had a wide range of expectations, but that these expectations were rarely met. First, they wanted to be able to quickly access services when they felt a need to consult, for instance when having a toothache. Participants also wanted to deal with caring and experienced dental professionals, which was not always the case according to them. They wished that large families and the elderly could access dental hygiene counseling and support in their homes and gathering places. In conclusion, we would like to make three key recommendations: to improve access to dental services, especially in emergency situations; to train dental professionals in patient-centered approaches and to know more about the Cree culture; and to dialogue with Cree people in developing, implementing and evaluating oral health services.

Tang Chi-wing, Wendy = 飲品味道對炎熱中運動的華籍男女小童之體液平衡及體温調節之影響 / 鄧稚穎.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2003.
Includes bibliographical references (leaves 74-86).
Text in English; abstracts in English and Chinese.
Tang Chi-wing, Wendy = Yin pin wei dao dui yan re zhong yun dong de hua ji nan nü xiao tong zhi ti ye ping heng ji ti wen diao jie zhi ying xiang / Deng Zhiying.
Dedication --- p.i
Acknowledgements --- p.ii
Abstract --- p.iii
Table of Contents --- p.vi
List of Tables --- p.viii
List of Figure --- p.ix
Chapter CHAPTER ONE --- INTRODUCTION --- p.1
Chapter 1.1 --- Background --- p.1
Chapter 1.2 --- Purpose of the Study --- p.4
Chapter 1.3 --- Hypotheses --- p.5
Chapter 1.4 --- Definition of Terms --- p.6
Chapter 1.5 --- Assumptions --- p.7
Chapter 1.6 --- Delimitations --- p.7
Chapter 1.7 --- Limitations --- p.8
Chapter 1.8 --- Significance of Study --- p.8
Chapter CHAPTER TWO --- REVIEW OF LITERATURE --- p.9
Chapter 2.1 --- Water Balance during Exercise --- p.9
Chapter 2.2 --- Effect of Dehydration on Human Body during Exercise --- p.11
Chapter 2.3 --- Physiological Responses of Dehydration for Children when Exercising in the Heat --- p.17
Chapter 2.4 --- Effect of Fluid Ingestion during Exercise --- p.20
Chapter 2.5 --- Drivers of Fluid Replacement --- p.23
Chapter CHAPTER THREE --- METHODOLOGY --- p.30
Chapter 3.1 --- Participants --- p.30
Chapter 3.2 --- Equipment and Instrumentation --- p.31
Chapter 3.3 --- Preliminary Measurement --- p.31
Chapter 3.4 --- Study Design and Procedures --- p.35
Chapter 3.5 --- Collection and Analysis of Blood Samples --- p.44
Chapter 3.6 --- Statistical Analysis --- p.44
Chapter CHAPTER FOUR --- RESULTS --- p.46
Chapter 4.1 --- Exercise Intensity --- p.46
Chapter 4.2 --- Body Fluid Balance --- p.50
Chapter 4.3 --- Thermoregulatory Responses --- p.61
Chapter 4.4 --- Taste Perception Analysis --- p.62
Chapter 4.5 --- Summary of the Results --- p.66
Chapter CHAPTER FIVE --- DISCUSSION --- p.67
Recommendations and Applications --- p.73
REFERENCES --- p.74
APPENDIXES --- p.87

no
Aims and objectives To (1) investigate the organisation, provision and practice of oral care in typical UK stroke units; (2) explore stroke survivors', carers' and healthcare professionals' experiences and perceptions about the barriers and facilitators to receiving and undertaking oral care in stroke units. Background Cerebrovascular disease and oral health are major global health concerns. Little is known about the provision, challenges and practice of oral care in the stroke unit setting, and there are currently no evidence-based practice guidelines. Design Cross-sectional survey of 11 stroke units across Greater Manchester and descriptive qualitative study using focus groups and semi-structured interviews. Methods A self-report questionnaire was used to survey 11 stroke units in Greater Manchester. Data were then collected through two focus groups (n = 10) with healthcare professionals and five semi-structured interviews with stroke survivors and carers. Focus group and interview data were recorded, transcribed verbatim and analysed using framework approach. Results Eleven stroke units in Greater Manchester responded to the survey. Stroke survivors and carers identified a lack of oral care practice and enablement by healthcare professionals. Healthcare professionals identified a lack of formal training to conduct oral care for stroke patients, inconsistency in the delivery of oral care and no set protocols or use of formal oral assessment tools. Conclusion Oral care post-stroke could be improved by increasing healthcare professionals' awareness, understanding and knowledge of the potential health benefits of oral care post-stroke. Further research is required to develop and evaluate the provision of oral care in stroke care to inform evidence-based education and practice.